Provider Demographics
NPI:1003238536
Name:LIFE CONCEPTS INC
Entity Type:Organization
Organization Name:LIFE CONCEPTS INC
Other - Org Name:QUEST, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:EAKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-218-4356
Mailing Address - Street 1:1509 E COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4704
Mailing Address - Country:US
Mailing Address - Phone:407-218-4300
Mailing Address - Fax:
Practice Address - Street 1:500 E COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4504
Practice Address - Country:US
Practice Address - Phone:407-218-4340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-17
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-13-5630103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018332800Medicaid
FL018332803Medicaid
FL018332801Medicaid